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Medicine: Mind the Gap, N-of-1 and Novel Within-Subject Trial Methods

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Air date: Monday, May 16, 2016, 11:00:00 AM
Time displayed is Eastern Time, Washington DC Local
Views: Total views: 172, (102 Live, 70 On-demand)
Category: Medicine: Mind the Gap
Runtime: 00:57:07
Description: Medicine: Mind the Gap

In a clinical encounter, both clinician and patient want the patient to achieve health behavior change, so the clinician reviews the evidence from between-subject randomized controlled trials and recommends the best intervention to the patient. However, due to the heterogeneity of response in the randomized controlled trial (RCT), we know it is unknown if the intervention will be successful for the individual patient.

The most scientifically rigorous—and potentially efficient—method for determining optimal clinical care for a specific patient is a single-patient (N-of-1) RCT, in which data are collected objectively, continuously, and in the real world for a sufficient time period to determine whether the intervention, compared to a placebo, another intervention, or a different type of delivery or schedule, is optimal for that particular patient. Systematic data collection can also obtain off-target changes for particular patients, so that a more complex picture can emerge about the overall therapeutic benefits and harms that can be attributed to the intervention for that patient. With sufficient data from several N-of-1 trials of the same design, we can engage in inductive phenotype identification, but N-of-1 trials are only useful under certain circumstances.

Evaluation Link:
https://www.surveymonkey.com/r/5XLXL96

For more information go to https://prevention.nih.gov/programs-events/medicine-mind-the-gap
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NLM Title: N-of-1 and novel within-subject trial methods / Karina W. Davidson ; NIH TV Studio.
Author: Davidson, Karina W.
NIH TV Studio,
Publisher:
Abstract: (CIT): Medicine: Mind the Gap In a clinical encounter, both clinician and patient want the patient to achieve health behavior change, so the clinician reviews the evidence from between-subject randomized controlled trials and recommends the best intervention to the patient. However, due to the heterogeneity of response in the randomized controlled trial (RCT), we know it is unknown if the intervention will be successful for the individual patient. The most scientifically rigorous--and potentially efficient--method for determining optimal clinical care for a specific patient is a single-patient (N-of-1) RCT, in which data are collected objectively, continuously, and in the real world for a sufficient time period to determine whether the intervention, compared to a placebo, another intervention, or a different type of delivery or schedule, is optimal for that particular patient. Systematic data collection can also obtain off-target changes for particular patients, so that a more complex picture can emerge about the overall therapeutic benefits and harms that can be attributed to the intervention for that patient. With sufficient data from several N-of-1 trials of the same design, we can engage in inductive phenotype identification, but N-of-1 trials are only useful under certain circumstances.
Subjects: Pharmaceutical Preparations
Randomized Controlled Trials as Topic--methods
Research Design
Publication Types: Lectures
Webcasts
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NLM Classification: QV 771.4
NLM ID: 101684401
CIT Live ID: 18989
Permanent link: https://videocast.nih.gov/launch.asp?19687